周欣　郑佳玉

[摘要] 目的 探讨阿司匹林联合低分子肝素治疗重度子痫前期的疗效。 方法 将我院2016年10月～2017年10月收治的重度子痫前期患者中抽取100例，按照入院号随机分为常规组与观察组，每组50例，常规组使用阿司匹林进行治疗，观察组使用阿司匹林联合低分子肝素进行治疗，治疗后比较两组患者的疗效、凝血功能及不良反应发生率。 结果 观察组患者的治疗疗效高于常规组，观察组PT、APTT高于常规组，FIB以及DD低于常规组，不良反应发生率低于常规组，差异均有统计学意义（P<0.05）。 结论 阿司匹林联合低分子肝素治疗重度子痫前期患者的疗效较好，可以改善妊娠结局，降低不良反应发生率，有很高的临床应用价值。

[关键词] 阿司匹林；低分子肝素；重度子痫前期

[中图分类号] R714.2 [文献标识码] B [文章编号] 1673-9701（2018）20-0085-03

Clinical effect of aspirin combined with low molecular weight heparin in treating severe preeclampsia

ZHOU Xin ZHENG Jiayu

Department of Obstetrics and Gynecology， Jiamusi Maternal and Child Health Hospital in Heilongjiang Province， Jiamusi 154002， China

[Abstract] Objective To analyze the efficacy of aspirin combined with low molecular weight heparin in the treatment of severe preeclampsia. Methods 100 patients with severe preeclampsia who were admitted in our hospital from October 2016 to October 2017 were randomLy divided into the routine group and the observation group according to the hospital admission number，with 50 cases in each group.The routine group was treated with aspirin. The observation group was treated with aspirin combined with low molecular weight heparin. After treatment， the therapeutic efficacy， coagulation function， and incidence of adverse reactions were compared between the two groups of patients. Results The study showed that the treatment efficacy of the observation group was higher than that of the conventional group. The PT and APTT were higher in the observation group than those in the conventional group， and the FIB and DD were lower in the observation group than those in the conventional group. The incidence of adverse reactions in the observation group was lower than that of the routine group， and the difference was statistically significant（P<0.05）. Conclusion Aspirin combined with low molecular weight heparin is effective in the treatment of severe preeclampsia， which can improve pregnancy outcomes， reduce the incidence of adverse reactions and has a high clinical value.

[Key words] Aspirin； Low molecular weight heparin； Severe preeclampsia

子癇是妊娠期在妊娠高血压疾病、子痫前期加重的基础上出现的比较严重的疾病，包括产前子痫和产后子痫。患者可能会出现抽搐、四肢僵直、口吐白沫甚至昏迷等症状，抽搐可反复发作，子痫是孕产妇四大死亡原因之一，如果处理不及时会导致胎死宫内，严重威胁孕妇及胎儿的生命安全。子痫前期由于患者血小板激活、血管内皮损伤、抗凝因子缺乏以及微血栓形成等因素，会呈现出易栓塞和高凝状态。在子痫前期的发生和发展过程中，抗凝系统失调和凝血具有推动作用。临床治疗重度子痫前期的药物主要有阿司匹林和低分子肝素，阿司匹林和低分子肝素治疗重度子痫前期患者能够降低妊娠期高血压、子痫发病、早产、胎儿宫内生长受限等风险。但是对于已经发生子痫前期是否具……